血清高敏C反应蛋白/白蛋白与急性冠状动脉综合征PCI术后对比剂肾病的相关性

Correlation between serum hypersensitive C-reactive protein/albumin and contrast-induced nephropathy after PCI for acute coronary syndromes

目的 分析血清高敏C反应蛋白(hs-CRP)/白蛋白(Alb)与急性冠状动脉综合征患者经皮冠状动脉介入(PCI)术后对比剂肾病的相关性。方法 选取我院接受PCI的496例急性冠状动脉综合征患者作为研究对象,根据PCI术后是否发生对比剂肾病分为对比剂肾病组(n=56)和非对比剂肾病组(n=440)。采用ELISA法检测患者术前血清hs-CRP水平,使用血液分析仪测定术前血清Alb水平,并计算hs-CRP/Alb。Logistic回归分析急性冠状动脉综合征患者PCI术后发生对比剂肾病的影响因素;受试者工作特征(ROC)曲线分析血清hs-CRP/Alb对急性冠状动脉综合征PCI术后对比剂肾病的预测价值。结果 与非对比剂肾病组相比,对比剂肾病组患者术前血清hs-CRP水平、hs-CRP/Alb均明显升高(P<0.001),Alb水平显著下降(P<0.001)。与非对比剂肾病组相比,对比剂肾病组患者术前肌酐水平、对比剂剂量明显升高(P<0.05);对比剂肾病组患者术后肌酐水平显著高于术前(P<0.05),术后血尿酸显著低于术前(P<0.05)。Logistic回归分析显示,hs-CRP、hs-CRP/Alb、肌酐水平、对比剂剂量是急性冠状动脉综合征患者PCI术后发生对比剂肾病的危险因素(P<0.05),Alb是保护因素(P<0.05)。ROC曲线显示,血清hs-CRP/Alb预测急性冠状动脉综合征患者PCI术后对比剂肾病的曲线下面积为0.965,截断值为0.19。结果 急性冠状动脉综合征患者术前血清hs-CRP/Alb较高与PCI术后发生对比剂肾病相关,其对急性冠状动脉综合征PCI术后发生对比剂肾病具有一定的预测价值。

Objective To analyze the correlation between serum hypersensitive C-reactive protein(hs-CRP)/albumin(Alb)and contrast-induced nephropathy after percutaneous coronary intervention(PCI)in patients with acute coronary syndromes.Methods A total of 496 patients with acute coronary syndromes who underwent PCI in our hospital were selected as the research subjects,and divided into the contrast-induced nephropathy group(n=56)and the non-contrast-induced nephropathy group(n=440)according to whether the contrast-induced nephropathy occurred after PCI.The preoperative serum level of hs-CRP was determined by ELISA,the preoperative serum Alb level was determined by hematology analyzer,and the hs-CRP/Alb was calculated.Logistic regression was used to analyze the factors influencing the occurrence of contrast-induced nephropathy after PCI in patients with acute coronary syndromes.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum hs-CRP/Alb in contrast-induced nephropathy after PCI for acute coronary syndromes.Results Compared with the non-contrast-induced nephropathy group,the preoperative serum hs-CRP level and hs-CRP/Alb of patients in the contrast-induced nephropathy group both significantly increased(P<0.001),and the Alb level significantly decreased(P<0.001).Compared with the non-contrast-induced nephropathy group,the preoperative creatinine level and contrast dose of patients in the contrast-induced nephropathy group both increased(P<0.05);the postoperative creatinine level of patients in the contrast-induced nephropathy group was higher than that before operation(P<0.05),and the postoperative serum uric acid of patients was lower than that before operation(P<0.05).Logistic regression analysis showed that the hs-CRP,hs-CRP/Alb,creatinine level,and contrast dose were the risk factors for the occurrence of contrast-induced nephropathy after PCI in patients with acute coronary syndromes(P<0.05),and the Alb was a protective factor(P<0.05).ROC curve showed that the area under the curve of serum hs-CRP/Alb was 0.965 in predicting contrast-induced nephropathy after PCI in patients with acute coronary syndromes,with a cut-off value of 0.19.Conclusion Higher preoperative serum hs-CRP/Alb of patients with acute coronary syndromes was associated with the development of contrast-induced nephropathy after PCI,which has certain predictive value for the development of contrast nephropathy after PCI in acute coronary syndromes.